Product Security and Telecommunications Infrastructure Bill

Debate between Baroness McIntosh of Pickering and Lord Kamall

3rd reading
Wednesday 19th October 2022 Lords Chamber

[Baroness McIntosh of Pickering (Con)]

I rise briefly to support the noble Earl, Lord Lytton, and to thank him and his Cross-Bench colleagues, the noble Earl, Lord Devon, and the noble Lord, Lord Cromwell, for the Cross-Bench support that we have enjoyed, together with that from the opposition Benches. My noble friend Lord Northbrook has also fought a valiant fight.

I thought it important from these Benches to place my regret that the 2017 electronic communications code has been harsher in its effects than had previously been anticipated. This was an opportunity to review that. So, while I did not support the Labour Front-Bench amendment, this is a good opportunity next door to consider whether there is cause, as I believe there is, to review the legislation at this stage.

I regret the imbalance in relationship that the Bill will expedite between the operators and landowners, many of whom are not private landlords but are sports clubs and others that will find the loss of income quite substantial and very difficult to replace at this time, in particular with the cost of living crisis and the inflation that we have seen. I regret that the alternative dispute resolution mechanism will not be mandatory; perhaps that is something the Government might like to consider when they look at this next door.

I will end on a local note. This is something that potentially could impact very positively in north Yorkshire. However, there are two issues that the Minister may not be aware of, as he is relatively new to this brief. One is that there are a number of existing masts owned by a specific telecoms operator that have not been operational. You have to ask the question, since the permissions have been given and the masts are in place, why on earth are they not being operated, in a place with one of the poorest levels of connectivity in the country. The other is looking at alternatives such as piggybacking on the back of the telecommunications masts that were put in place at public expense for the North Yorkshire Police service. I can see absolutely no reason why we cannot piggyback on the back of those.

With those few words, I wish the Bill well, particularly its Part 1—we will gloss over some of the later parts—as it proceeds in its passage through Parliament.

[Lord Kamall (Con)]

My Lords, I apologise as, in my quest to be concise, I did not name specific noble Lords and I think it is right that I do that. I thank the noble Baroness, Lady Merron, and the noble Lord, Lord Bassam, for their warm welcome. Indeed, it is a re-welcome from the noble Baroness, Lady Merron; many noble Lords will know that she and I have worked together before—we are inextricably linked. I also thank their adviser, Dan Stevens. I thank the noble Lords, Lord Clement-Jones and Lord Fox, and of course their adviser, Sarah Pughe. We take the credit for it, but these advisers work incredibly hard.

I acknowledge the continuing concerns of the noble Earl, Lord Lytton, and of other noble Lords who spoke on this issue. As I have said, I remain open to further meetings and am very happy to discuss these things. I commend the Bill to the House.

Product Security and Telecommunications Infrastructure Bill

Debate between Baroness McIntosh of Pickering and Lord Kamall

Report stage
Wednesday 12th October 2022 Lords Chamber

[Baroness McIntosh of Pickering (Con)]

I am following very carefully what my noble friend has said. He just said that responses to the consultation were received. The offending articles were not part of that consultation, so the Government have not actually heard any responses from the interested parties on that point.

On his point about Clauses 63 and 64 remaining part of the Bill, which is why we cannot remove Clauses 61 and 62, my reading of Clause 63 in particular relates to new tenancies. My noble friend has not responded to the points raised by both the noble Earl, Lord Devon, and me about existing agreements that are going to be renewed, rather than new agreements.

There are two points to which I would like the Minister to respond: first, this issue was not part of the consultation so the Government have not received any responses on it. Secondly, what happens to existing agreements being renewed under Clause 63? Are they to be slashed by 90% without any recourse?

[Lord Kamall (Con)]

I thank my noble friend Lady McIntosh for those questions. I will come to them—I am sorry, maybe I am not going as fast as noble Lords would hope me to, but I wanted to consider carefully the various points made by noble Lords, and I still have specific responses to come to. If noble Lords will allow me to talk to Amendment 24, I will come back to the contributions made during the debate.

Amendment 24, tabled by the noble Earl, Lord Lytton, but spoken to by the noble Earl, Lord Devon, looks to prevent interim rent being backdated where an agreement is renewed under the 1954 Act, and is similar to the amendment tabled by the noble Earl in Committee. One of the fundamental aims of the Bill is to ensure that the approach to renewing agreements across part 5 of the code, the 1954 Act and the 1996 order is as consistent as possible. As my noble friend Lord Sharpe said in Committee, this form of amendment serves only to increase inconsistency. It would create inconsistency within the 1954 Act itself, preventing backdated payments of interim rent where a site provider gives notice under Section 25 of the Act, yet would allow interim rent to be backdated where an operator serves notice under Section 26 of the Act.

The ability to backdate rent is not a new concept. It is not being introduced into the 1954 Act by this Bill, nor was it introduced in the 2017 reforms. When parties entered into these agreements, there was always a risk that the market could change between the time it was entered into and the time of its renewal and that the amount of rent could decrease. However, the Government have listened to stakeholders representing the interests of site providers and understand the potential consequences of applying the code valuation framework to the 1954 Act and the 1996 order agreements in relation to backdated interim rent. This is something that is being carefully considered in developing an implementation strategy, including such transitional provisions as may be needed to bring the different provisions of the Bill into force in a timely and responsible manner.

Let me now talk to some of the points made by noble Lords. A number of noble Lords said that the evaluation regime is not fair. The Government see the pricing regime as being closely aligned to utilities such as water, electricity and gas. The Government maintain that this the correct position. Landowners should still receive fair payments that take into account, among other things, alternative uses that the land may have and any losses or damages that may be incurred.

It should be noted that, in many of the examples of unfair rent or large percentage reductions that have been raised by campaign groups, reference is made only to the rental payment itself. These examples fail to take into account any compensation payments which the landowner may have received under the agreement. They may also have failed to take into account any capital payment which the landowner may have received upfront as part of the terms of the agreement. There have been some paid studies of raised examples of poor negotiations or rent reductions. It would not be appropriate for me to comment on ongoing negotiations in specific terms, but the Government say generally that rent is often only one part of the overall financial terms agreed, as I said earlier. As regards behaviour during negotiations and the respective bargaining positions of the parties, the Government have recognised site provider concerns and are introducing measures to encourage greater collaboration.

The noble Earl, Lord Devon, and other noble Lords mentioned the reluctance to enter into new agreements. We have been told that the amounts offered by some operators are so drastically reduced that landowners are less willing to come forward and allow their land to be used. However, I have been advised that, so far in 2022, at least 107 agreements have been reached in relation to new sites, with heads of terms agreed on a further 66 sites. This is in addition to 533 renewal agreements which have been concluded this year, along with heads of terms agreed on a further 119 renewals. The Government maintain that the 2017 valuation provision created the right balance, and they are aware that the valuation framework would have resulted in some reductions, as I said earlier.

I think it was the noble Earl, Lord Devon, who talked about middlemen who take profits overseas. The benefits of independent infrastructure provision are globally acknowledged. An Ernst & Young report in February this year, produced by a European-wide infrastructure association, highlighted the many benefits which independent infrastructure providers bring to both the industry and consumers. It talked about sharing towers and costs and enabling cheaper rollout. The report concluded that the scope of independent infrastructure providers overcharging for the use of the infrastructure would be constrained by continued competition between tower companies.

Government policy introduced in the 2017 valuation framework to reflect the public interest in digital infrastructure and encourage investment while driving costs down remained unaltered. That is not to say that we approached our pre-consultation engagement with a closed mind, but that engagement with stakeholders did not indicate that the valuation framework is incapable of delivering both our policy objectives and fairer outcomes for landowners. It did highlight difficulties with communication and negotiations, hindering the framework from working as intended. We hope that the Bill and the non-legislative initiatives we are taking forward will tackle this.

There have been some claims that rents would reduce by more than 40%. In the impact assessments in 2016, the Government specifically said that they did not know what effect the reforms would have on rental payments. There is reference in the impact assessment to independent analysis which predicted a 40% decrease. Some lobby groups have asserted that this figure demonstrates that the Government committed that rent reductions would be no more than 40%. The Government maintain that this was not a government commitment, but it did appear in the impact assessment and we expected the market to adjust.

As I said, rent is only one element and other variations occur in practice. We understand the various things that have been said by various companies. A number of noble Lords reflected on the CEBR research. The Government have problems with the report from the CEBR. First, the picture the report paints of government policy is incomplete and partial. Secondly, the alternative changes the report proposes do not account for key challenges, which in our view means that they would not deliver the results the CEBR suggests. The report focuses excessively on the prospective interests of landowners and we are trying to get the right balance.

On the Institute of Economic Affairs, I should be very clear and have to declare my interests. I am the former academic and research director of the institute, so I would not wish to comment one way or the other on its report, but I know that it used as its source some of the work from the CEBR’s and other reports. My successor, Dr James Forder, is an excellent analyst and economist. Indeed, he is the economics tutor at Balliol College in Oxford—I digress.

I am afraid that, while I completely understand the arguments—I have had conversations with a number of noble Lords and am very grateful to those who have come to meetings and heard the Government’s perspective—we cannot accept these amendments. Perhaps in vain, or in aspiration, I ask noble Lords to consider not pressing them.

General Practitioners: Shortage

Debate between Baroness McIntosh of Pickering and Lord Kamall

Tuesday 12th July 2022 Lords Chamber

[Baroness McIntosh of Pickering (Con)]

I beg leave to ask the Question standing in my name on the Order Paper and declare my interest with the Dispensing Doctors’ Association.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

The Government recognise that growing the GP workforce is challenging, particularly in light of pressures from the pandemic. There are over 1,400 more full-time equivalent doctors in general practice in March this year compared with March 2019, showing that there is some movement in the right direction. However, we need to go further, and we are working with NHS England and NHS Improvement, Health Education England and the profession to boost recruitment, address the reasons why doctors leave and encourage them to stay or return to practice.

[Baroness McIntosh of Pickering (Con)]

I am grateful for that Answer, but my noble friend will be aware that by 2030, we will be facing an acute shortage of GPs as more doctors leave the profession than join. There are 9 million people living in remote rural, coastal and island communities, which is more than live in London. Will my noble friend ensure that all health policy is rural-proofed, and that those living in rural areas have equal access to healthcare to those living in urban areas?

[Lord Kamall (Con)]

My noble friend makes a very important point, and she referred continually throughout the passage of the Health and Care Act to practices in rural areas. We have looked at the challenges and have asked GPs about this in surveys, and we know that there are problems about the reduction of working hours, administrative burdens, some stress and burnout, and some issues about equitable distribution. One thing we do have is the Targeted Enhanced Recruitment Scheme launched in 2016, which has attracted hundreds of doctors to train in hard-to-recruit areas by providing a one-off financial incentive.

Polio

Debate between Baroness McIntosh of Pickering and Lord Kamall

Thursday 23rd June 2022 Lords Chamber

[Lord Kamall (Con)]

First, I thank the noble Lord for his recognition of one of the challenges of ministerial office, as he will know from his own experience. It is important that we recognise that vaccine-derived polio has the potential to spread, but it is rare and the risk to the public overall is limited. The majority of Londoners are fully protected against polio and will not need to take any more action, but the NHS will begin reaching out to parents of children under five in London who are not up to date. But we are asking for it both ways and for parents to check their records. Let us be clear that the UK is considered to be free from polio, but we recognise a potential risk given our world-leading surveillance of sewage.

On the noble Lord’s specific question, we are quite clear that people must come forward for all vaccines. Sometimes during lockdown people were unable to see a doctor or nurse in person, and the NHS is catching up with that anyway, but the NHS will keep sending the message to try to identify people who have not been vaccinated. At the same time, we are encouraging people to check their records. Let us be clear: we detected this very early in the chain, and it has perhaps come from someone who took an oral vaccine overseas and has excreted it into the system.

[Baroness McIntosh of Pickering (Con)]

I congratulate the UKHSA and the Environment Agency on the investment they have made. When was the polio first detected—there are reports that it was detected as early as February—and when might they be able to narrow down the area in which it has been found?

[Lord Kamall (Con)]

I thank my noble friend for that question. There is routine surveillance that happens anyway. However, in this case they have detected it in more than one surveillance. Quite often, it is seen as a one-off and then not seen again for some time; in this case, it has been detected at each interval of the surveillance. We know it is from the Beckton Sewage Treatment Works—in that part of London. I must be careful about the words I use here: clearly, it is mixed up with a lot of other stuff, and we must now work out how we go along the pipe, as it were, and investigate individual pipes to see whether we can locate the source. In theory, it might be possible to find individual households or streets but it is too early to do so. What we are doing here is really world-beating: it is a first and shows that we are ahead. However, one issue in being ahead is that we detect things that would not have been detected earlier, and people are worried about them.

Health Protection (Coronavirus, Restrictions) (Self-Isolation etc.) (Revocation) (England) Regulations 2022

Debate between Baroness McIntosh of Pickering and Lord Kamall

Monday 14th March 2022 Grand Committee

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

My Lords, over the course of this pandemic, we have had to put in place curbs on our liberties. Many of those curbs would at one time have seemed intolerable, but they were part of our national effort to slow the spread of the virus. We have now reached the position that we have been waiting for ever since this national effort began: a time when we can roll back some of the rules that have governed our lives over the past two years.

We are able to take this step because of the incredible progress that we have made; I thank noble Lords for alluding to that in the previous debate. When this virus first arrived, we knew very little about it. People were dying. There was no vaccine. We had to make tough decisions to protect our loved ones, our healthcare staff and the British people while we built up the defences to make us safe.

Since then, our vaccination programme has put more than 140 million doses in arms. That has included a booster programme where we were the first major European nation to boost half our population. It has resulted in more than 70% of adults in England receiving the booster, including 93% of those aged 70 and over. Vaccines have given us greater protection and slowed down the advance of the virus. They have allowed us cautiously to open up the country and attempt some return to normal life. The scientific protection that we have built up, together with our greater understanding of the virus, has shifted the odds.

We must be quite clear that our fight against the virus is not over, but we are now able to take a different approach, moving away from legal curbs towards an approach based on personal responsibility and public health guidance, where we trust people to make the right decision for themselves, for their loved ones and for those around them. I hope that noble Lords will bear with me while I talk through each measure in turn.

First, the legal requirements around self-isolation are being revoked. This includes the duty to self-isolate if you test positive, the duty to provide NHS Test and Trace with details of contacts, the duty to notify an employer that you are self-isolating and the legal duty on employers not knowingly to allow someone who is self-isolating to attend work.

Rather than relying on legal restrictions, we are encouraging people to act responsibly and to follow the guidance that has been set out. If you experience any of the main symptoms of Covid-19, you should take a test. These symptoms are a new continuous cough, a high temperature and a loss of or change in your normal sense of taste or smell. People who test positive should still stay at home and avoid contact with others for at least five full days. They may choose to follow this advice until they have received two negative test results on consecutive days.

Household contacts are also advised to work from home if they can and to avoid contact with individuals who are at greater risk from Covid-19. They should also limit close contact with other people outside their household and wear a well-fitting face covering in enclosed spaces. Following this advice for 10 days after the case’s symptoms started, or the day their test was taken if they did not have symptoms, can help to protect others. Specific guidance for staff, in particular those in vulnerable settings, such as adult social care, healthcare and prisons, is being kept under review and regularly updated.

The other regulations being revoked today are the Health Protection (Coronavirus, Restrictions) (England) (No. 3) Regulations 2020. These gave local authorities powers to issue directions to close, prohibit and restrict premises, events or outdoor places. They also gave the Secretary of State powers to require a local authority to issue a direction for closure. These regulations were vital for a local response to the crisis, allowing us to act with speed in response to local outbreaks, but these powers have not been used since July last year and we are now seeing fewer outbreaks, meaning that they are no longer proportionate or necessary. With these regulations revoked, outbreaks will be managed by local authorities through local planning and pre-existing public health powers, as they would be with other infectious diseases.

Although we are able to take these steps, we must remember that this pandemic is not over. There are simple actions we can all take to limit the spread of Covid-19 to protect those around us: get vaccinated, ventilate shared spaces, wear a face covering in crowded or enclosed spaces, get tested if you have Covid-19 symptoms and stay at home if you are positive. It is important that those who test positive for Covid-19 follow the public health advice to stay at home and avoid contact with others for at least five days.

We are taking additional steps to protect the most vulnerable with targeted vaccines and treatments, including offering spring boosters as we announced and the protection offered by antivirals, of which we have a greater supply per head than any other country in Europe.

In our surveillance to build up our resilience to manage and respond to new variants, we will continue to rely on the world-leading ONS survey, allowing us to track the virus in granular detail. We will make sure that we still have the ability to ramp up testing should we need to and will help countries across the world to develop their own capability for surveillance. These defences will be our first port of call in the future, rather than relying on legal restrictions, while we maintain our vigilance.

The regulations we are debating today restore some freedoms to our nation, but we have to make sure we maintain our vigilance and continue to rely on a scientific evidence approach to keep us safe. I commend these regulations to the Committee.

[Baroness McIntosh of Pickering (Con)]

My Lords, I thank my noble friend, both for his Answer to my Question earlier, which I would like to pursue in more depth here, and for moving the regulations today. I also pay tribute to the work that he, the ministerial team and the department have done. They have worked exceptionally hard in challenging circumstances. I declare my interest as an adviser to the board of the Dispensing Doctors’ Association.

I understand, as my noble friend said in response to my Question earlier, that the department and the Government are reaching a balance in living with Covid. The context of these regulations must be set against that background. My concern is that we are still relying on the vaccination programme. I pause and say how welcome the vaccination and booster programme has been. I particularly welcome the fourth jab being rolled out to the most vulnerable. It seems slightly patchy: we heard earlier that some in London have a date for their vaccination, but hearsay and anecdotal evidence are that people are being told that they will have a vaccination but have no date yet.

My main concern is simply this. The Secretary of State has said publicly, and my noble friend has repeated it in the House and in Committee today, that the Government hope to respond and keep the development of the pandemic under review. I welcome that but my concern is very simple: that we are removing all the tools to enable the Government to do so.

--- Later in debate ---

[Baroness McIntosh of Pickering (Con)]

I am most grateful to my noble friend for repeating the responsibilities of the local authorities. Were they allocated special funds to do this or are they just relying on their existing public health budgets? In other words, are they not getting any new money for this role?

[Lord Kamall (Con)]

I am afraid I do not have a detailed answer, and I do not want to give an inaccurate one. I think I know the answer but I just want to double-check it. I will write to all noble Lords, as more than one Member raised that issue.

We see the importance of continuing to be vigilant, and of surveillance. We continue to monitor the virus and want to make sure that we have informed decisions and that everything is data-led. A number of noble Lords mentioned the ZOE app. Again, I will have to go back to the department to find out more information, if noble Lords will allow me.

In closing the debate, I thank noble Lords for their contributions. I apologise for the questions I have not answered; I will check Hansard and write to noble Lords. We should also thank the scientists, the health and social care workers, the volunteers, the life sciences industry, the postal, courier and transport workers and everyone who has helped us to get to this point. They have helped us to get through what has been a very difficult period in our lives.

We believe that the regulations before the Committee mark an essential step on our journey to living with Covid, away from legal restrictions and towards guidance and personal responsibility. Once again, I am grateful to noble Lords for raising their concerns, some of which I will have to go back to the department and check on, especially concerning the guidance and its communication. I have taken that point on board.

Throughout the pandemic we have sought to strike the right balance between the safety of the public and keeping the country open. We saw restrictions as a vital weapon in the armoury, but now we have the defences of the vaccination programme and the antivirals, along with a better scientific understanding of the virus, and can take a different approach. However, I repeat: we will keep monitoring the data, drawing on the latest scientific advice, and protecting the country through the defences we have built.

It is important that we follow public health advice should we display Covid-19 symptoms or receive a positive test result. We can all help each other in limiting the spread of the virus by getting vaccinated, ventilating shared spaces, wearing a face covering in crowded or enclosed spaces, getting tested if we have Covid-19 symptoms and staying at home if positive. Lifting these restrictions does not mean that we are ignoring the virus; it means managing the virus through the best possible guidance, as we do for other infectious diseases. I urge noble Lords to agree to these historic measures and commend the regulations to the Committee.

Covid-19: Restrictions

Debate between Baroness McIntosh of Pickering and Lord Kamall

Monday 14th March 2022 Lords Chamber

[Baroness McIntosh of Pickering (Con)]

My Lords, I beg to ask the Question standing in my name on the Order Paper, and I refer to my work with the Dispensing Doctors’ Association.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

Throughout the pandemic, the Government’s approach has been informed by a wide range of scientific and medical advice and the latest data, as well as by economic, social and deliverability considerations. Ministers have always had regard to the scientific advice when taking decisions to implement or remove restrictions, but have balanced them against other considerations.

[Baroness McIntosh of Pickering (Con)]

Given that the level of infections is now running at 220,000 new infections per day, and given the fact that the Government are planning to remove free testing from 1 April and have already removed the legal obligation to self-isolate, having already removed the support payments for self-isolation, how do the Government intend to protect the most vulnerable in society and NHS staff, given the Government’s new policy provisions of Living with Covid-19?

[Lord Kamall (Con)]

I thank my noble friend for those questions and will try to answer them as best I can. We are now transitioning to a stage where we are able to live with Covid, and we have just announced our living with Covid strategy. At the same time, we are looking at the best way to help those who are particularly vulnerable medically or economically, who should still be entitled to free tests, for example, and issues such as affordability. We continue to monitor the new variants, the BA2 and the deltacron, and we will also continue to have the ONS surveys.

Health and Care Bill

Debate between Baroness McIntosh of Pickering and Lord Kamall

Lords Hansard - Part 1 & Report stage
Tuesday 1st March 2022 Lords Chamber

[Lord Kamall (Con)]

My Lords, in moving Amendments 4, I shall also speak to Amendments 23, 58 and 79 in my name. Before I start, I really should acknowledge the contribution and engagement of a few noble Lords, in particular the noble Lords, Lord Sharkey and Lord Patel, and my noble friends Lady McIntosh and Lady Blackwood for their constructive engagement with me and my officials.

We have seen the power of research as we have made our way through the pandemic, and research will continue to be essential. I agree that research needs to be embedded in the very DNA of the NHS. Earlier this week, I chaired a round table with a number of research charities and other stakeholders, and we all talked about the importance of embedding research into the NHS. A bit like the challenge I had when I was in academia, when you wanted more time for research but at the same time were told to get on with your day job of teaching students, likewise many clinicians are under the same pressures in terms of the day-to-day delivery of healthcare while wanting time for research.

We know that informed research helps to improve healthcare and health outcomes. It brings benefits to patients, staff, the NHS and the wider economy. We believe that integrated care boards will play a leading role facilitating and enabling research and fostering a culture and environment for research to flourish. To this end, the Bill currently places a duty on each ICB that it

“must, in the exercise of its functions, promote … research on matters relevant to the health service, and … the use in the health service of evidence obtained from research.”

I have, however, heard clearly from noble Lords that they want to see a step change in research. That is a request, or a plea, that I agree with, so rather than directly funding or conducting research, ICBs will primarily facilitate and enable it. However, ICBs will also have the power to conduct, commission or assist the conduct of research. This could include hosting or being a collaborating partner in research infrastructure.

I also heard from noble Lords, particularly the noble Lord, Lord Sharkey, that it is not clear what a duty to promote research should involve. To that end, I have tabled Amendments 4, 23 and 79 to clarify that the meaning of “promote” includes “facilitate”. I once again thank the noble Lord, Lord Sharkey, for his engagement. This highlights that facilitation is a subset of the range of activities meant by promoting research while retaining the breadth of a duty to promote research.

The duty is broad and could be met in a number of ways. For example, when exercising its commissioning functions, an ICB may select providers which have a proven track record of being research-active or can demonstrate the intention and capability to participate in research. The provision is also flexible so that bodies can develop the processes and structures that work most effectively, but we anticipate that ICBs would have dedicated research offices or teams to support their role in research and to encourage the conduct of research.

To ensure that research is fully embedded in local systems, we expect ICBs to consider research when preparing, with the responsible local authority, a joint strategic needs assessment articulating local research needs where they identify them. We would also expect ICBs to ensure that the joint local health and well-being strategy sets out how research needs can be met by the ICB. We have tabled Amendment 35, which is to be debated in the next group, to ensure that the research duty, along with other duties, is given particular consideration during ICBs’ planning of their strategies. We have also tabled a package of amendments to provide increased transparency, accountability and oversight of the research duties.

During the debate in Committee, my noble friend Lady Harding remarked that

“what gets measured gets done”.—[Official Report, 24/1/22; col. 47.]

We agree. Amendment 4 requires NHS England’s business plan to explain how it proposes to discharge its research duty and requires its annual report to contain an assessment of how effectively it discharged this duty. We have tabled similar amendments for ICBs. Amendment 55, also to be debated in the next group, would require that ICB annual reports must explain how the ICB has discharged its research duty. Amendment 58 would require that the NHS England’s performance assessment of each ICB includes an assessment of how well it discharged its research duty. I beg to move.

[Baroness McIntosh of Pickering (Con)]

My Lords, I take this opportunity to thank my noble friend for listening and acting in the terms set out in the amendments in this group, which I support on research as far as they go. I have to express my disappointment that my noble friend has not seen fit to extend his bonhomie to NICE. I have therefore tabled Amendment 29, and I am delighted to have the support of the noble Lords, Lord Hunt of Kings Heath and Lord Patel. As set out by the noble Lord, Lord Kakkar, our thoughts are with the noble Lord, Lord Patel, who is unable to be with us today, and we wish him the speediest possible recovery. It is a great shame that he cannot be here today because we would all wish to pay tribute to his work historically as the forerunner of NICE. We are grateful to him for it. It is a great disappointment to me that he is not able to be here in person.

I also support Amendments 171 and 178 in the name of the noble Lord, Lord Hunt, but I shall leave the noble Lord to set them out.

My noble friend has set out that the government amendments set a responsibility on integrated care boards to respond annually and to measure the research work that they have done. Quite frankly, I am a little concerned and gobsmacked as to why my noble friend is not insisting that integrated care boards do the same as regards NICE. The key provision of my Amendment 29 is:

“Within 28 days of any medicine or device receiving market authorisation from NICE, an integrated care board must update its formulary to include that medicine or device.”


I have set out other provisions, but the other one to which I draw attention is in proposed new subsection (3), which says that every year an individual ICB must report

“in a publicly accessible format”—

to me that would mean it being accessible on its website—

“all medicines and devices that have been added and removed from their formulary over the previous year and maintain an active list of all medicines and devices available on their formulary.”

Vaccination: Condition of Deployment

Debate between Baroness McIntosh of Pickering and Lord Kamall

Thursday 3rd February 2022 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Baroness for raising that point. It is really important to note that, when engaging in debates such as this, it is sometimes easy to forget patients, and we should not do that. The health service should be all about patients; it should be patient-centred. I understand the concerns. One of the reasons that we originally introduced VCOD, particularly for care homes and then more widely, was that patients were very concerned and relatives of patients were concerned about their loved ones—they were terrified, given the early outbreaks that we saw in care homes. On the particular consultation, I am afraid that I do not have the information with me, but I will commit to write to the noble Baroness.

[Baroness McIntosh of Pickering (Con)]

I thank my noble friend for answering questions on the Statement here this afternoon. One thing that struck me when I read through it was that

“Incredibly, over a third of the UK’s total number of covid-19 cases have happened in just the last eight weeks.”—[Official Report, Commons, 31/1/22; col. 71.]


Taken together with the point raised by one of the noble Baronesses on the Front Benches—that the Government are planning to stop publishing the level of Covid infections and deaths, and to stop testing from the end of March—what reassurance can he give us this afternoon that the Government will know where the infection is and what the level of infection is? Against that background, how does my noble friend expect to protect the NHS and care homes at that time?

[Lord Kamall (Con)]

I thank my noble friend for her question. I will be frank with her: I was not aware that the Government intend to stop publication, so I will have to go back to the department and double-check whether that is indeed true or whether it is a qualified statement. I commit to write to all noble Lords, given that it seems to be what we have heard. Clearly, as we are told, we follow the evidence, and the scientists continue to follow the evidence, so I would expect that data to continue to be collected. The best answer I can give at this stage is that I will go back to the department and investigate, and will write to noble Lords.

Personal Protective Equipment: Accounting

Debate between Baroness McIntosh of Pickering and Lord Kamall

Wednesday 2nd February 2022 Lords Chamber

[Lord Kamall (Con)]

The noble Lord asks a detailed question, so I hope noble Lords will forgive me if I try to respond in some detail. If you look at the breakdown of the writedown, you will see that, first, about £4.6 billion was attributable to changes in global prices following the point of purchase in a highly inflated market—noble Lords will remember that even toilet rolls went up at one time. As the noble Lord rightly says, the £673 million was for stuff that had failed the quality testing or technical insurance. The £2.6 billion was for stock that will not be used for its intended purposes but can be repurposed. We are also looking at stock in excess of the current forecast requirements, which can be stockpiled, and we are also introducing a tender for testing to see whether the life of some of that stock can be extended.

[Baroness McIntosh of Pickering (Con)]

My Lords, can I press my noble friend a little more closely on one issue? I speak as president of the UK Warehousing Association. I am grateful to my noble friend for his explanation. What timetable do the Government have to remove this redundant PPE equipment from the warehouses in which it is currently situated to enable stock to be stored in those warehouses which really needs to be at this time?

[Lord Kamall (Con)]

There are different ways; some of it is about stockpiling stuff that is still useful and which we would use in future anyway. We are looking at research into testing whether the life of some of our stock can be extended—we are working with some of the best scientists on that. We are also looking at where we can give stock away or sell it on, as all the stock we are passing on meets WHO standards. To give noble Lords one example, we bought lots of latex gloves; usually we do not buy latex gloves in this country because of allergies and, now that we no longer need them, we can give them to a country such as Syria.

Health and Care Bill

Debate between Baroness McIntosh of Pickering and Lord Kamall

Committee stage
Thursday 20th January 2022 Lords Chamber

[Lord Kamall (Con)]

Perhaps I may suggest, following the interventions of both noble Lords and their experience of being Health Ministers and of NICE, arranging a follow-up meeting with them to discuss this matter in more detail so that I can understand the situation more. As I am sure noble Lords will appreciate, I have been in this job for only four months and am still learning an awful lot. In fact, I am learning far more in this Committee than I have in my first four months. That shows that sometimes there is no substitute for learning on the job.

NICE has a suite of more than 300 guidelines and, as the noble Lord, Lord Stevens, said, more than about 1,900 medicines, spanning the whole of health and social care. It makes dozens of recommendations that can be complicated. We do not think it proportionate or feasible to require compliance with NICE guidelines but, given what I have just mentioned, I should like to consult previous Health Ministers with experience in this area and perhaps have further discussions to see what is relevant in the future.

I shall end with the CQC reviews of ICSs. We will look more broadly at the entire system of how the ICS areas are performing. A requirement for the CQC to specifically consider compliance with NICE guidelines as part of these reviews risks adding a considerable burden to this process. I can, however, assure the Committee that the Government expect the healthcare system to take NICE’s recommendations fully into account, subject to what noble Lords have told me about the performance of some CCGs. I am also aware that NICE works closely with system partners to support implementation where possible. It is probably best henceforth for me to have those conversations with the two noble Lords and any others with experience of this matter. There are more than two former Health Ministers in this House and we should have those conversations.

Let me see if I can answer some of the specific questions. As regards VPS—how do I put this in the most diplomatic way?—I have been asked to look at that issue. The industry has complained, for example, because we also have therapeutic tendering at the same time as expecting this. I am grateful to my right honourable friend the Secretary of State for asking me to look into this issue in further detail. I have asked what would happen, for example, when some of the life sciences companies ask whether it makes the UK less attractive in some ways. I am assured that it does not but I am looking into this issue as part of the life sciences aspect of my portfolio.

I think that I have covered all the questions but all that I ask at the moment is to let me have further conversations. That is probably best. In that spirit, I ask noble Lords to consider withdrawing or not moving their amendments.

[Baroness McIntosh of Pickering (Con)]

My Lords, I am grateful to all who have contributed to this debate and for the number of issues that have been raised.

At the outset, the noble Baroness, Lady Brinton, highlighted and a number of us focused on the hurdles—as the noble Baroness, Lady Merron, described them—to be overcome. However, there has been a lot of focus on the problems of the budgetary challenge. It would be incumbent on my noble friend the Minister to meet not just with the two noble Lords he highlighted but the drafters of the amendments: myself, the noble Baroness, Lady Finlay, the noble Lords, Lord Hunt and Lord Warner, and the noble Lord, Lord Patel, who sat so patiently through the whole of today’s proceedings and had to leave before this discussion was reached. As he had such success in the mental health meeting, I hope that we replicate that and take up a number of the issues raised here.

Public Health: Night-time Working

Debate between Baroness McIntosh of Pickering and Lord Kamall

Thursday 6th January 2022 Lords Chamber

[Lord Kamall (Con)]

I think all your Lordships would agree on the incredible dedication of our medical and health and social care staff, before and particularly during the pandemic. We have to remember that a lot of these conditions are governed by the Health and Safety Executive guidance on managing health and safety risks, which includes guidance on shift work and fatigue, to make sure employees are treated with as much dignity and respect as possible.

[Baroness McIntosh of Pickering (Con)]

My Lords, the Wilf Ward Family Trust is a charity that looks after severely disabled adults in north Yorkshire. Following the court case last year over pay for sleep-in shifts, it has had great difficulty in filling these roles and reaching an accommodation with the staff. Could my noble friend look into this—perhaps I could have a word with him afterwards—to see if that situation has been resolved to the satisfaction of both the adults in care and those providing that care?

[Lord Kamall (Con)]

As my noble friend will appreciate, I cannot comment on the details of a specific case, but I would welcome a conversation with my noble friend. The general issue has to be that we make sure that patients are treated as well as possible but that staff and employers are treated with as much as dignity as they deserve.

Covid-19 Update

Debate between Baroness McIntosh of Pickering and Lord Kamall

Wednesday 8th December 2021 Lords Chamber

[Lord Kamall (Con)]

The noble Baroness makes an important point. Let us hope that the NHS will fix it. As the NHS says, it is aware of the issue and will try to fix it and update as soon as possible. But, clearly, if that is not possible, we will have to update the guidance, and I will take that back to the department.

[Baroness McIntosh of Pickering (Con)]

My Lords, I think that my noble friend said that the peak of the omicron infection rate is expected in January. Will he confirm that the lateral flow testing will last through January to March if that is the case? Will he join me in congratulating the Dispensing Doctors’ Association, with which I declare my interest as an adviser, on rolling out specifically the programme to which my noble friend Lord Naseby referred of vaccinating the housebound? Can he look into the fact that the Covid pass that is issued reflects only two vaccines and not the booster vaccination?

[Lord Kamall (Con)]

I pay tribute to my noble friend for making us aware of the dispensing doctors, and for making people like me, who are much more urban-centred, aware of some of the issues in rural areas. On the Covid pass, up to now, in most countries it has not been a requirement to have the booster shown in order to travel. Clearly, all countries will now be updating their travel requirements and restrictions. I am afraid I have a terrible short-term memory. What was the first question?

[Baroness McIntosh of Pickering (Con)]

Lateral flow tests.

[Lord Kamall (Con)]

Yes. Given the advice on testing, especially if you are pinged and have to test, clearly we will make sure that there are sufficient tests available.

Coronavirus Act 2020 (Early Expiry) (No. 2) Regulations 2021

Debate between Baroness McIntosh of Pickering and Lord Kamall

Tuesday 30th November 2021 Grand Committee

[Lord Kamall (Con)]

I apologise if I was not clearer before. I thank the noble Baroness for taking advantage of the opportunity to ask that question and finding the urge to do so irresistible. On theatres and cinemas, one of the things that was put to us was that in a restaurant, you are constantly taking a mask on and off, whereas in a cinema or theatre you are not really eating that much. Okay, you might well go to buy your ice cream—I do not know whether they still sell ice cream and jelly babies in theatres, or whatever it used to be; this will look very odd in Hansard when someone reads it—but you are not constantly doing and you are more or less constantly wearing your mask. However, I will take that back. It is a fair point, and one thing that I do when I am being briefed is to challenge because I know that noble Lords will rightly challenge me on this issue.

In response to the comments by Jenny Harries, I hope I have been clear that we take advice from a range of advisers and there is not yet consensus, but we have been relying not just on making mask mandatory when necessary as a precaution, but at the same time on people’s individual behaviour and them acting responsibly. It is about getting that balance right. We listen to Dr Jenny Harries, but she is one of a number of experts whom we listen to. We weigh up the different views; it is as simple as that. As we have been clear, there is no one trigger for any of these measures. We always consider a range of measures, including capacity in the NHS, the trends et cetera. I have listed them in previous debates. It is not one person whom we listen to. We listen to a range of experts.

[Baroness McIntosh of Pickering (Con)]

Will my noble friend undertake to write to me about waiting facilities in GP waiting rooms? That would be helpful. I am also prompted by a question that I do not think he responded to from the noble Baroness, Lady Brinton, on the welfare aspects of staff shortages in meat-processing plants and the massive cull of pigs. While I appreciate it might not be the direct responsibility of his department, this is an animal welfare disaster about to happen.

One thing that I did not like to raise—I am sure it will go no further than the Grand Committee, which is why I feel confident to raise it now—is that my noble friend will be aware that there is PPE equipment which was deemed not fit for use, but it is in the system and is, to a certain extent, clogging up the supply chain by taking space which should be used for other goods. Will he undertake to use his good offices to look into this? Perhaps we could have a word about it afterwards because it is contributing to shortages and delays in the supply chain, particularly in storage terms.

[Lord Kamall (Con)]

First, I apologise for missing that point earlier. Regarding the supply chain provision, an SI was laid under the draft affirmative procedure on 21 April 2021. It was debated and approved by both Houses, came into force on 16 July and expired the provision. As the noble Baroness rightly acknowledged, some of her questioning was not within the scope of these regulations. However, given that she has asked a question, I will endeavour to find out the answer. Clearly, that will include going across departments, so I hope that she will be patient as I try to get that answer as quickly as possible.

On GP access, we recognise the pressure that general practitioners are under, especially in the upcoming and challenging winter period. We are investing £250 million in the winter access fund to improve GPs’ practice capacity. I will take the noble Baroness’s specific question about square metres and areas back to be answered; I hope she understands that I do not have those facts to mind.

The issue of measures was also raised. We must remember that one of the counterpoints put is that the country is in a very different position to the one it was in last year, due to the vaccination programme. Some of the restrictions that might have seemed appropriate last year are not as appropriate this year because we have reduced the link between cases and hospitalisations, as well as between hospitalisations and deaths. Clearly, we have the vaccine. I am sorry if I sound like a broken record but we continue to push the vaccine because it helps to break that link; it is part of the reason why we will not have to go back to some of the restrictions—those similar to last year’s—that many noble Lords are pushing for.

All I will say is that the Government’s autumn and winter plan set out how we will sustain and strengthen some of the progress made so far. We all know that winter will be a challenging period, but more so over the next few months. We all have a role to play in fighting the virus. There is much that government can do but sometimes, even when we mandate things, we know that there will be people who do not obey, so we must get the balance right and decide how to get the appropriate enforcement. Together, we believe that we can protect the progress that we have made, protect the NHS in the months ahead and help friends, loved ones and ourselves by being vaccinated against Covid-19, getting a flu jab if eligible and sticking to the advice on how to keep safe.

I thank noble Lords for their contributions to this debate and previous ones on the Coronavirus Act; I also thank them in advance for future contributions. I welcome noble Lords’ expertise and contributions, and I commend the regulations to the Committee.

NHS England: Waiting Lists

Debate between Baroness McIntosh of Pickering and Lord Kamall

Tuesday 16th November 2021 Lords Chamber

[Lord Kamall (Con)]

The noble Lord made a very perceptive intervention last night when asking us to think outside the box, and I gave an example of someone who I know suffers from asthma and forgot to take his blue inhaler with him to another city. His wife went to a number of places to try to get an inhaler from the pharmacy and from A&E, while telling him to stay in his hotel room. In the end, he was told that the only way to get an inhaler was to call the ambulance. We need to think outside the box and be more creative about when those situations occur—it is not necessarily political, but we need to be creative.

On technology, one of my jobs is Minister for Technology, Innovation and Life Sciences. I have been forceful, when talking to the NHS, that we have to digitise and share data. I accept that there are some concerns over sharing data, but the way to have an NHS that is fit for purpose is to make sure that we digitise and share data.

[Baroness McIntosh of Pickering (Con)]

I refer to my work with dispensing doctors. Will my noble friend join me in paying tribute to all the workforce of the NHS? Does he recognise that they are absolutely exhausted? The BMA has forecast that thousands of doctors will leave the profession in the next few years. Will the Government undertake to reinstate the commitment to have 6,000 more doctors by 2024?

[Lord Kamall (Con)]

In our conversations with the NHS, we are talking about the workforce plan. We are looking at ways to improve the way in which the NHS and social care plan for their workforce. We have committed to continuing to reflect very carefully on points made by noble Lords across the House. honourable Members in the House of Commons and many stakeholders. It is important that we value the workforce of doctors, nurses and other healthcare workers whom people often forget about. We should also value all those other workers who have provided services to us during lockdown, such as delivery drivers, postal workers, Amazon workers et cetera. They have all played a vital role, and we should not forget the role of civil society organisations.

Alcohol Duties

Debate between Baroness McIntosh of Pickering and Lord Kamall

Tuesday 2nd November 2021 Lords Chamber

[Lord Kamall (Con)]

The World Health Organization and a number of other organisations have criticised the current system of taxation of alcohol, and urged the Government—and the EU when we were a member of it—to move toward taxation based upon the volume of alcohol. To answer the noble Baroness’s specific question, there are no current plans to implement minimum unit pricing in England, but the Government continue to monitor the impact of minimum unit pricing as evidence emerges from Scotland and Wales. It has been in place in Scotland for more than three years, and the Scottish Parliament will not consider its extension until April 2024. In all my conversations with various public health experts, one of the things that they make quite clear is that this has to be evidence-led, and we want to look at evidence from elsewhere.

[Baroness McIntosh of Pickering (Con)]

I declare my interest as chairman of the PASS Proof of Age Standards Board. I also chaired the Select Committee on the Licensing Act 2003. Does the Minister agree with the Committee when it said:

“It is in our view unarguable that an increase in the price of alcohol will decrease consumption.”?


Does he further agree that, by increasing the taxation on stronger alcohol as the Budget aims to do, that will have a better chance of reducing alcohol intake and dependency than the minimum unit pricing that we have seen in Scotland?

[Lord Kamall (Con)]

I thank my noble friend for that very important point. This is why the new system of taxation has been introduced. It will more directly align the volume of alcohol with the taxation on it. That will feed through to higher prices for drinks with higher alcohol content.